The higher prevalence of autism reported in blind children has been commonly attributed to the confounding effects of an underlying intellectual disability. The aim of this study was to explore the relationship between symptoms of autism and blindness in adults with intellectual disability. We hypothesized that blindness can increase the probability of the autism phenotype, independent of known risk factors, that is, severity of intellectual disability and gender. A general population case register (population size of 0.7 million) was used to conduct two studies. The first study was on 3,138 adults with intellectual disability, using a validated autism risk indicator to study adults with visual impairment. This identified 386 adults with partial and complete visual impairment, both of which were associated with presence of high number of autistic traits (P < 0.001). The second study was only on those with congenital blindness using a standardized assessment tool, the Pervasive Developmental Disorder-Mental Retardation Scale. Those with hearing impairment or unilateral, partial, and acquired visual impairment were excluded. Control groups were randomly selected from those with normal hearing and vision. Prevalence of the autism phenotype was higher among those with congenital blindness (n = 46/60; 76.7%) than their controls (n = 36/67; 53.7%) and this association was statistically significant (adjusted odds ratio = 3.03; 95% confidence interval: 1.34-6.89; P = 0.008). Our results support the hypothesis that a congenital blindness independently affects psychosocial development and increases the probability of the autism phenotype. Early identification of autism could facilitate appropriate psychosocial interventions and educational opportunities to improve quality of life of people with blindness.Lay Summary: Although autism has been commonly reported in those with blindness, it is generally attributed to an accompanying intellectual disability. Current study, however, revealed that congenital blindness is independently associated with symptoms of autism. In spite of its high prevalence, autism can be overlooked in those with intellectual disability and blindness. Improving diagnosis in this population should, therefore, be advocated through raising awareness of this association to facilitate early access to services.

Background: Deaf sign language users encounter many barriers to accessing local services and receiving appropriate help and treatment. As a result Deaf 1 people with serious mental illness can fall through the net of service provision. Aims: To identify and explore the issues involved in providing care for Deaf people with serious mental health problems from the perspective of community mental health teams (CMHT). Method: Eight focus groups were used to explore perceptions and experiences of providing care for this population. Discussions were recorded and transcribed verbatim and analysed using thematic analysis. Data analysis was supported by ATLAS-ti, (Scientific Software Development, 1997) a software package for coding and organising qualitative data. Results: Five key themes were identified: (1) CMHT lack of skills/knowledge/resources, (2) Communication difficulties, (3) Distance of specialist Deaf services, (4) Joint working between CMHT and specialist Deaf services, and (5) Issues specific to Deaf patients. Findings are discussed in the context of implications for improving the access and provision of care for Deaf people with severe mental illness. Conclusions: CMHTs frequently feel ill equipped to provide care for Deaf patients with severe mental illness. Implications require ongoing attention to ensure a more collaborative and efficient continuity of care.

SummarySensory (visual and hearing) impairment has significant detrimental impact on sociocognitive and language development. Despite this, it is very much underrecognised and underdiagnosed in people with intellectual disability. Raising awareness of sensory impairment among professionals and carers is extremely important for early management to prevent further social handicap in people with intellectual disability. This article reviews sensory impairment in intellectual disability and its association with autism-spectrum disorder and mental illness.

Purpose-There are currently more than 12 million cancer survivors in the USA. Survivors face many issues related to cancer and treatment that are outside the purview of the clinical care system. Therefore, understanding and providing for the evolving needs of cancer survivors offers challenges and opportunities for the public health system. In 2004, the Centers for Disease Control and Prevention and the Lance Armstrong Foundation, now the Livestrong Foundation, partnered with national cancer survivorship organizations to develop the National Action Plan for Cancer Survivorship (NAPCS). This plan outlines public health strategies to address the needs of cancer survivors. To date, no assessment of NAPCS strategies and their alignment with domestic cancer survivorship activities has been conducted.Methods-The activities of five national organizations with organized public health agendas about cancer survivorship were assessed qualitatively during [2003][2004][2005][2006][2007]. Using the NAPCS as an organizing framework, interviews were conducted with key informants from all participating organizations. Interview responses were supplemented with relevant materials from informants and reviews of the organizations' websites.Results-Strategies associated with surveillance and applied research; communication, education, and training; and programs, policy, and infrastructure represent a large amount of the organizational efforts. However, there are gaps in research on preventive interventions, evaluation of implemented activities, and translation.Conclusions-Numerous NAPCS strategies have been implemented. Future efforts of national cancer survivorship organizations should include rigorous evaluation of implemented activities, increased translation of research to practice, and assessment of dissemination efforts.Implications for Cancer Survivors-The results of this descriptive assessment provide cancer survivors, cancer survivorship organizations, researchers, providers, and policy makers with initial information about cancer survivorship public health efforts in the USA. Additionally, results suggest areas in need of further attention and next steps in advancing the national cancer survivorship public health agenda.

The optimal management of sleep problems is a significant challenge, particularly in patients with psychiatric illness, because disturbed sleep is a known risk factor for relapse. This study used the short Dysfunctional Beliefs and Attitudes Scale to assess beliefs about sleep in adults with acute psychiatric disorders (N=100) recruited from inpatient and outpatient clinics. The subjects showed highly dysfunctional beliefs and attitudes about sleep and held diverse opinions about, but had low confidence in, their own capacity for optimal sleep management. They did not report excessive daytime sleepiness. We conclude that individuals with acute psychiatric illness worry significantly about their sleep and hold more dysfunctional beliefs about sleep than people without psychiatric illness. The absence of excessive daytime sleepiness in this sample, although counterintuitive, is consistent with findings in other studies. Given that two thirds of the sample expressed interest in non-pharmacological strategies to better manage their sleep problems, cognitive reshaping therapies appear to have clinical potential as alternatives to hypnosedative medication once a comprehensive sleep workup has excluded a physical sleep disorder such as obstructive sleep apnea. Dysfunctional beliefs and high concern about sleep offer potential targets for psychotherapy.